Bone fragility and sarcoidosis: An underestimated relationship

Area of Science:

• Rheumatology
• Pulmonology
• Endocrinology

Background:

• Sarcoidosis is a multisystem inflammatory disease that can affect bone, leading to reduced bone mineral density (BMD) and increased fracture risk.
• Existing data on BMD and fragility fractures in sarcoidosis patients are limited and inconsistent.

Purpose of the Study:

• To characterize the prevalence of fractures and identify risk factors in patients with sarcoidosis.

Main Methods:

• A cross-sectional study evaluated 252 sarcoidosis patients and age/sex-matched controls.
• Bone mineral density (BMD) was measured at the lumbar spine, femoral neck, and total hip.
• Fragility fractures and vertebral fractures (using Genant's method) were assessed. Lung function tests (FEV1, FVC, DLCO) were performed.

Main Results:

• Sarcoidosis patients had lower BMD at the lumbar spine and total hip compared to controls.
• BMD values correlated significantly with diffusion capacity for carbon monoxide (DLCO).
• The prevalence of fragility fractures was higher in sarcoidosis patients (30.6%) versus controls (12.3%). Patients with ≥3 vertebral fractures showed poorer lung function.
• Multiple regression indicated BMI positively associated with fractures, while BMD, DLCO, and therapy use were negatively associated.

Conclusions:

• Vertebral fractures are a frequent complication of sarcoidosis.
• The number of vertebral fractures correlates with worsened pulmonary function, suggesting disease severity impacts bone fragility.